Kenya
Map of Kenya
Overview
Kenya’s International Emerging Infections Program (IEIP) was initiated in 2004 as a collaboration between the Ministry of Health (MOH) of Kenya and the U.S. Department of Health and Human Services (HHS). The IEIP-Kenya program is based at the Kenyan Medical Research Institute (KEMRI) in Nairobi and Kisumu, and national, provincial and district health bureaus actively participate in program operations. In addition, other Kenya-U.S. HHS/Centers for Disease Control and Prevention (CDC) collaborations for addressing infectious diseases include the Field Epidemiology and Laboratory Training Program (FELTP), influenza activities, Immigrant and Refugee health, and the Global AIDS Program. Regionally, IEIP-Kenya also collaborates with the World Health Organization, including the Integrated Disease Surveillance and Response (IDSR) program.
The IEIP program in Kenya has developed 5 core activity areas: population-based surveillance, technical support for outbreaks, epidemiologic research, training, and integration of laboratory and epidemiology programs into larger, international networks. Collectively, these activities are enhancing the diagnostic and epidemiologic capacity in Kenya, providing a platform to conduct public health research of national and global importance, and aiding in dissemination of proven tools for disease prevention and control. Program activities are directed by an executive committee of senior public health officials from the Kenya MOH’s Department of Disease Control, KEMRI, and the U.S. CDC.
Selected Activities
Kibera urban settlement, Nairobi
Population-based surveillance for emerging infectious diseases
IEIP-Kenya conducts population-based surveillance to identify and characterize important and emerging pathogens, establish public health priorities in rural and urban settings, and provide a mechanism for evaluating the impact of interventions for priority diseases. Surveillance operations focus on key infectious disease syndromes (pneumonia, diarrhea, febrile illness and jaundice) and their etiologies in two geographic areas of Kenya, a Nairobi slum (Kibera) and a rural community in Kisumu. Other major surveillance components of the program include joint operations with IDSR, a national reporting system for influenza, and a Immigrant and Refugee health collaboration for disease monitoring in a refugee camp.
Technical support for outbreak investigations
Outbreak investigations in Kenya and the region have called for assistance from IEIP-Kenya. In collaboration with ministries of health and other partners, the program has provided epidemiologic and laboratory expertise for prevention and control of cholera, meningococcal disease, avian influenza, chikungunya fever, Rift Valley fever, brucellosis, typhoid fever, leptospirosis, and aflatoxicosis. Partner programs, including WHO, CDC, and U.S. Naval Medical Research Unit No. 3, have provided subject matter expertise during these investigations.
Epidemiologic research on disease burden and prevention and control
The programs’ core activities provide a platform for epidemiologic research on infectious diseases in Kenya. Since 2004, several research projects have been conducted, including:
- Evaluation of the effectiveness of a new rotavirus vaccine;
- Assessments of potential public health interventions, including introduction of safe water, promotion of hand washing, and zinc treatment for diarrheal illness; and
- A Global Enterics Multi-center study (GEMS) of disease burden.
Epidemiology and laboratory training and capacity-building
IEIP-Kenya works closely with CDC’s Field Epidemiology Training Program in Kenya. Four cohorts of FELTP participants have completed the program to date. These graduates have received degrees in applied epidemiology and laboratory management, and have returned to work in the Kenya MOH as well as 5 other counties in the region. FELTP participants have also been directly involved in the outbreak investigations described above, thereby receiving immediate, ‘hands-on’ professional experience. The IEIP program is also helping to develop both the technical capacity of Kenya’s laboratorians as well as the national and regional laboratory infrastructure. Regionally, the CDC-IEIP laboratory serves as a training center, provides technical and material support, and functions as a testing center for influenza.
Key Accomplishments
- Active, population-based surveillance for key infectious disease syndromes in rural and urban settings has been established. Forty staff members have been trained to conduct field interviews using wireless PDAs for data collection and monitoring of acute episodes of illness. Surveillance provides first-of-its-kind public health data for a slum community.
- IEIP-Kenya has provided technical support for outbreak investigation and control in Kenya, Uganda, Nigeria, Ethiopia, and southern Sudan. Examples include surveillance, infection control, and communication measures to reduce likely avian-to-human transmission of avian influenza; meningococcal meningitis case detection and laboratory diagnosis, vaccine interventions, and appropriate treatment for cases at health centers; malaria case detection, case management, and promotion of vector-control measures in a refugee camp; and laboratory diagnosis of cholera with promotion of water treatment and public health messaging to reduce the risk of contamination.
- Research activities are advancing the evidence and knowledge base on infectious disease threats. Epidemiologic studies focus on the burden and etiologies of pneumonia, diarrheal, and febrile illnesses. Additional pathogen-specific research has included molecular and entomologic studies on Rift Valley fever and development of capacity to fully characterize Chikungunya.
- IEIP-Kenya collaborates with the Ministry of Health and WHO on IDSR, which is improving the availability and use of surveillance and laboratory data for control of priority infectious diseases that are the leading cause of death, disability, and illness in Africa.
- The program has initiated human and animal surveillance studies on Rift Valley fever in Northeastern and Rift Valley provinces of Kenya, where the disease in endemic.
- To strengthen preparedness for avian and pandemic influenza, IEIP-Kenya co-hosted a surveillance training workshop in Uganda, which included representatives from 13 African countries. In addition, IEIP has sponsored or participated in several other train-the-trainer workshops focusing on rapid response to avian influenza. Partnerships with ministries of Health, WHO, CDC, and NAMRU-3 have extended these workshops to engage medical epidemiologists, veterinarians, communication specialists, and laboratorians from Nigeria, Kenya, Uganda, Tanzania, Ethiopia, South Sudan, Rwanda, and Cote d’Ivoire. Influenza surveillance activities have also been established, including population-based surveillance for influenza and avian influenza in one entire district to establish incidence rates; sentinel surveillance for influenza, avian influenza, and severe acute respiratory illness (SARI); and H5N1 surveillance of migratory birds as part of multi-country collaboration.
Page last modified: February 8, 2008